


Pathogenesis and Intervention

by astolat



Category: House M.D.
Genre: M/M, backdated, epidemic
Language: English
Status: Completed
Published: 2005-01-18
Updated: 2005-01-18
Packaged: 2017-11-25 12:09:16
Rating: Explicit
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 6,284
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/638754
Author URL: https://archiveofourown.org/users/astolat/pseuds/astolat
Summary: <blockquote class="userstuff">
              <p>Drawing connections.</p>
            </blockquote>





	Pathogenesis and Intervention

**Author's Note:**

  * Translation into 中文 available: [发病机理与介入治疗](https://archiveofourown.org/works/756908) by [styx](https://archiveofourown.org/users/styx/pseuds/styx)



> With many thanks to Basingstoke and tzikeh for betaing!

James gave up and brought the nurse over at lunch after a few more days, his look daring House to say anything. House smiled and kept on his best behavior. "Linda," he said with relish, rolling it around on his tongue, after she'd gone back inside.

"Shut up," James said.

"Nice legs," House said.

Predictably, James showed up at his apartment two weeks later, mussed and tie-less and guilty, and proceeded with only minimal prodding to confess in lurid detail the fun which had most definitely been had by all. He finished up by giving House a blowjob, which was only fair as he was responsible for the hard-on, and spent the night in his bed. He was always easiest right after he'd already been cheating.

James made good coffee and better scrambled eggs, and drove him into work, which meant they'd be going home together after. Life was pretty much as good as it got from House's perspective. "Good morning, gentlemen," he said, breezing into the conference room. "Where's the lovely Dr. Cameron?"

"She's visiting Elise," Chase said.

"Who?"

"The woman with sleeping sickness," Foreman said with an exasperated look.

"Oh. Why? Has she had a relapse?" House poked through the mail, muttering, "Boring, boring, boring, junk mail, boring, ooh." He tucked the new issue of Maxim under his arm. "Boring, boring." He tipped the pile of letters into the garbage.

"I think maybe she feels sorry for her," Foreman said. "You know, with her husband leaving her in the hospital and all."

"Since when is she a psychiatrist?" House said. "Get her and go do some rounds. See if there are any interesting cases."

"Wait, hold on a minute," Chase said, getting up. "You _want_ us to find you a case?"

"I want you to find me an _interesting_ case," House said. "Note the important placement of the adjective." He hummed a little as he went into his office, smug at the expressions on their faces, and sat down to kill an hour or two reading about Found Porn and _The_ _Sexiest_ _Women_ _of_ _Sports_! As a bonus, one of the Sexiest Women bore a passing resemblance to the long-legged Linda.

Cuddy dampened his mood by hunting him down mid-day and sending him off to the clinic. "Wait a second, I already did my hours this week," he protested.

"We've got a full house, one of the scheduled doctors is out sick himself, and you, unlike every other physician on staff, have zero cases," she said.

"What about Elise? She's in a delicate psychological state right now, you know," he said.

"Last time I checked, you weren't a psychiatrist, for which your patients can thank God," Cuddy said. "Get out there."

She wasn't lying about the crowd, and a couple of people had ensured it would be a really special experience by throwing up in the waiting room and adding that particular fragrance to the general ambience. "You," House said, pointing to one particularly greenish specimen, figuring he might as well head off any more doses.

"Hey, I was here before her," a balding older man said.

"Do I look like I care? Besides, you don't have an ulcer, you just need to cut your fiber intake and stop eating Mexican food. Go home and take some Mylanta," House said. "Come on," he told the woman.

She really did look pretty rotten, but her chart said she was generally in good health, no asthma, no anemia. "How long have you been vomiting?"

"Just now," she said ruefully. "I was okay until that other woman went off, then boom."

"What other symptoms? Aches and pains?"

"Yeah, really bad," she said. "I couldn't get out of bed this morning."

"Coughing, sneezing, sore throat?"

"No, just sore, you know? And tired."

He got up and pulled out the stethoscope. "Breathe in," he said, listening. "Your chest is clear. Any unusual stress at work lately?"

"Nothing unusual, but I guess it's always pretty stressful," she said. "I work for the Midtown South precinct."

"Police, huh?"

"Well, I'm actually a domestic violence counselor, myself," she said. "But yeah."

"Any cases getting you down?"

"Man, they always get me down," she said, with a short laugh. "But you just got to get through it to do the job, you know? Nothing special lately."

"Well, looks like what you have here is a nasty case of the flu," he said, putting away the stethoscope. "It should get better after a couple of days. Rest, drink warm fluids, take over-the-counter meds for the pain."

"Nothing else you can give me for it?" she asked. "I've already missed two days with this thing."

"There are lots of things I could give you for it," House said as he left the room. "Antibiotics, antifungals, prescription painkillers. They wouldn't actually help you get better any quicker, but I suppose at least you'd feel like you were doing something. Forget it. Go home and sleep."

"There is a flu antiviral, you know," Wilson said, meeting him at the desk. "Give me fifteen minutes, Janice, I need some coffee," he told the nurse at the desk, handing over the chart.

"She's already been sick for two days, it's useless," House said. "Besides, that thing's overkill for anyone who's not high-risk for complications. What are you doing down here?"

"I had a couple of cancellations, so I came down to help fill in," Wilson said.

"Avoiding Linda already? Trouble in paradise?"

"I am not avoiding -- oh, forget it," he said, and went off muttering. House called another patient in cheerfully.

"I can't have the flu," the man said fretfully. He was sweating like a pig, and mopping his face with the back of his hand. "I got a flu shot."

"They're not effective against all possible strains," House said absently, listening to the man's chest. "Your chest's clear, no complications. How'd you get a flu shot, anyway? We had a shortage this year."

"I'm a medical worker," he said defensively.

"You are?" House eyed him.

"I work at NYU Medical Center."

"Uh huh, doing what, exactly?" House said, putting away his stethoscope. "Wait, let me guess." He looked over the chart. "Mr. Roebler. Says here you've been in with RSI complaints, back spasms. So I'm guessing, what, insurance claims office?"

"I don't need this attitude," Roebler said, pulling on his shirt. "You try getting anything done in this place without a support staff sometime, see how well you do."

"Ooh, touchy," House said, as he stormed out. "Next!" he called.

"I'm sorry to bother you," the next patient said apologetically. "I don't usually come in for just the flu, but it's been four days now with this fever, and I was starting to get worried."

"Well, you don't have any congestion," he said. "Sore throat, runny nose?"

"No, none of that," she said. "Not coughing either. I just don't seem to be getting any better. I thought it might be mono? One of my TAs had it earlier this year."

"Been making it with him on the side?" House asked.

"Her, and no!"

"Well, mono is transmitted through saliva, so it's not very likely otherwise. Open wide," he said, pushing down her tongue. "Hm."

"Uauagh?" she asked.

"Well, you don't have mono, but you do have some red spotting in here," he said. "No sore throat, you said?"

"No, not at all," she said, when he took the depressor out of her mouth.

"Have you been having any chronic pain before the fever started? Soreness anywhere?" She shook her head. "Okay, I'm going to have a nurse come in and do some bloodwork and a throat culture on you," he said. "It might be an unusual case of strep, in which case we'll put you on some antibiotics."

She nodded, and he went outside and poked his head into the exam room next door. "Hey, Wilson," he said. "Take a look at the patient in exam room 2, for me, will you? She's got prominent erythroplakia."

Wilson nodded. He came back out after a few minutes. "You ordered bloodwork?"

"Yeah," House said.

"I wouldn't rule it out without more information, but it doesn't look characteristic of cancer to me," Wilson said. "Too spotty, really, and she's got them on her tongue too."

"Hm," House said, and went back in. The nurse was already tapping her. "Where do you work?" he asked her.

"Parsons," she said.

"And that is...?"

"Parsons School of Design," she said, a little indignantly.

"Design? What kind? Do you work with any unusual chemicals?"

She smiled. "I'm a computer illustration teacher."

"Interesting," he said. He went out and took one of the empty exam rooms and sat down to read the rest of the Maxim.

Wilson tapped on the door half an hour later. "Bloodwork shows slightly low white blood count, nothing really dangerous, and the culture is negative for strep."

House put down the magazine. "You had a lot of flu cases today?"

"Well, yes. 'Tis the season."

"Presenting with aches and pains, no congestion?"

"Some of them, yeah, but that's not that unusual," Wilson said. "What are you thinking?"

"Admit her for observation," House said, getting up. "Also, let's call back my other two patients. I think we might have a new strain on our hands."

"Wait a second, you don't seriously want to call in the CDC because we have a bunch of flu cases in the middle of January?" Wilson said. "They'll put you up against the wall and shoot you."

"She's had a high fever lasting four days," House said. "That's potentially fatal for the elderly and at-risk, so it meets the morbidity standards. And the flu shot isn't effective against it. We should at least get a surveillance team down here."

"Have fun breaking the news to Cuddy," Wilson said.

* * *

"And once again, you start seeing a catastrophe where no reasonable evidence exists," Cuddy said. "At least you're moving up in the world. A flu pandemic is way sexier than a minor contamination in the maternity ward."

"Excuse me, but in case you hadn't noticed, I was _right_ that time," he said.

"That's absolutely true," she said. "And you proved it, _first_ , before I started ringing the alarms. Convince me and I'll make the call, but three patients in a row presenting with completely standard symptoms does not a new pandemic make."

"Fine," he said, and went to collect his flock.

"We didn't find anything really interesting," Chase said, jumping up: all three of them were sitting around the conference table eating pizza and playing Scrabble with a battered old set they'd probably stolen from a waiting room somewhere.

"Oh, I disagree. _Mulcted_ is a very interesting word," House said. "Fifty point bonus and a triple word score, nice. It's too bad we have this annoying thing called work to do. Did we have any patients admitted with fever, muscle aches, prostration?"

"Yeah, there were a few," Foreman said. "The flu is interesting?"

"It is when it's not the flu, at least not the flu we know," House said. "What were the ages?"

"Uh, average, I guess?" Chase said, looking at Foreman and Cameron for confirmation. "Nobody old or young, anyway. We didn't really pay that much -- "

"Never mind," House said. "Cameron, you go get histories on all the patients presenting with fever, aches and pains, and specifically no congestion. Check their mouths and tongues for spotting. Also, I just had a patient from the clinic admitted, keep an eye on her condition. Chase, Foreman, you start making calls." He pushed the phone across the conference table. "I want to know numbers of patients admitted with similar symptoms at area hospitals."

"You think we've got a pandemic," Foreman said incredulously.

"I think we're going to find out. Get to work." House went into his office.

Wilson dropped by a few hours later and leaned against the door. "Very nice," House said, glancing up.

"What?"

"That's a good pose for you," House said. "Shows off your legs and shoulders. Bet you used that on Linda."

"Sometimes you make me want to strangle you."

"As long as it's only sometimes, I'm still ahead of the game. You ready to go?"

"If you can tear yourself away from the developing pandemic."

"That's what minions are for," House said, collecting his bag. "Page me if you find anything interesting," he told Foreman and Chase.

Foreman tucked the receiver down against his shoulder. "How long do you want us to keep doing this?"

"Well, duh. Until you find something interesting," House said, and ignored their outraged expressions.

"You are a cruel, cruel man," Wilson said.

"I try," House said.

* * *

He woke up fumbling at the bedside table: the pager was buzzing and sliding all over the place, knocking up against the pill bottle. James groaned next to him and sat up rubbing his face. "See, this is why it's not a good idea to torture your minions too much. What time is it?"

"Four am," House said. "Come on."

"Why am I coming?"

"Because they found something interesting."

"Or they found something just interesting enough to use as an excuse to page you at four in the morning," Wilson said, climbing out of bed and getting his pants.

Chase and Cameron were sitting in the waiting room, looking washed-out and tired. "Well?" House said.

"The patient you admitted, Katherine Jenson. Her fever is going up," she said, doing a briefly confused double-take at seeing Wilson. "It hit 104 and we're having a hard time bringing it down."

"Aha," House said.

"And her viral culture came back negative for influenza," Chase said. "We're testing her for mono now."

Wilson sighed and rubbed his face.

"Goddamn it, she does not have mono," House said, annoyed. "What about other hospitals?"

"Some hospitals had a lot of cases, others didn't," Chase said. "We've been having a hard time tracking down anyone to ask since around 7pm, though."

"Any pattern?"

Chase shrugged. "Not that we noticed."

"Well, let's check that again, then," House said, limping off towards his office. Foreman was just hanging up the phone, and looking fairly murderous. House ignored him and dug around in his desk for a map and some pushpins.

"Okay," he said, sticking it on top of the dry-erase board. "Here we are. How many cases do we have?"

"Are we counting the woman with mono?" Chase asked snidely.

"Cute," House said. "Yes."

"With Katherine, we have seven admitted," Cameron said with a sigh.

"Okay, five to ten cases will be blue," House said, and stuck in a pin on top of the hospital. "Next?" Wilson got up and took the box of pins away from him and pushed him at a chair.

It took about fifteen minutes to go through the rest. "So, what have we got?" House said, studying the map. Mostly blues and whites, for zero to five cases, with a couple of orange.

"It looks pretty random to me," Foreman said.

"There's orange at Hoboken and Jersey City," Cameron said.

"They've got higher population density, though," Foreman said.

"Not higher than Newark, and there's pretty much nothing there," she said.

"Inconclusive," House said.

"I don't know, I'd say it is pretty conclusive," Foreman said challengingly. "If we were seeing an outbreak of a new strain, we ought to have a clear pattern of case density around an origin point. And that we definitely do not have. Not to mention, the most likely source of a new strain would be Newark Airport, and there is no activity around there."

House shook his head. "Not enough information," he muttered. "We're missing something."

Cameron's pager went off. "It's the nurses station on the third floor," she said. "That's where Katherine is."

* * *

"You wanted to know about any symptom changes," the attending said, leading them to the room. "She woke up a few minutes ago complaining about her throat, and she's got some lesions in there."

"She was negative for strep, right?" Chase said, trailing after. "What else causes throat lesions?"

"Herpangina," Cameron said. "But that's usually a childhood infection."

"Let's have a look," House said, and went in to peer at her throat. "Well, that's different. Those look pretty nasty, actually."

"My mouth hurts a lot," Katherine said, whispering.

"Is that a rash?" Wilson said, looking at her neck. He undid the hospital gown.

House looked at her bare shoulders, mottled with small blisters. "Get this patient into an isolation room stat," he said. "Lie down and keep your mouth closed," he told her, easing her back down. "Cameron, get me a surgical mask."

She reached out for his sleeve, scared, asking, "What's wrong with me?"

"Don't talk," House said, putting the surgical mask on her face, covering nose and mouth. A couple of nurses came in to move her, gloved and masked, and he stepped back to let them wheel the bed out. "We need a list of everyone who's been in contact with her since she developed the fever, and we need to get them in right now," he said. "Cameron, get a list from her and start calling. You," he said, pointing at the attending, "get everyone else we've been monitoring into isolation also."

"We don't have that many isolation rooms," he said.

"The entire top two floors of the hospital can be isolated in an emergency," Wilson said.

"Well, this would be one," House said.

"We'd have to move something like fifty patients," the attending protested. "I don't even know if we have the bed space -- "

"Shut up and get started," House said. "Triple people up in rooms if you have to. Foreman, go tell the staff on the tenth and eleventh floors to get ready to transfer patients downstairs. Chase, get downstairs and tell security to lock down the hospital. Nobody leaves."

"What is it?" Wilson asked quietly, while for a moment everyone stood staring.

"Smallpox," House said.

* * *

"Cute outfit," House said.

"Glad to see you haven't lost your sense of humor," Cuddy said, sitting down heavily in the chair Wilson vacated for her. The tracksuit really was cute, but she mostly looked tired, pale without any makeup. "Tell me what we've got."

"We've locked down ten and eleven," Foreman said. "Two more of the febrile patients have started developing lesions. We've cultured the rest of them, and for now we're keeping the ones with the rash on eleven, the others on ten."

"We've called in all hospital personnel," Cameron said. "And we're calling anybody who's been in the hospital since the first febrile patients were admitted, and patient contacts. We've been telling them to stay isolated and keep by a phone so we can contact them with vaccination instructions."

"And we've contacted all the other area hospitals with cases," Chase added. "They've isolated their symptomatic patients, at least, as much as they can."

"Good." Cuddy leaned back in the chair and closed her eyes for a second, pressing her fingertips against her eyelids. "Okay," she said, straightening up. "The CDC is on the way and bringing vaccine. We've been designated a contagious facility for the duration of the outbreak. St. Peter's has been designated residential. We're going to start transferring all of our non-smallpox patients over there as soon as they're ready, about half an hour. They'll be vaccinated there."

"Some of the cancer patients shouldn't be vaccinated," Wilson said. "Their immune systems are too compromised, and they haven't been exposed directly."

"How soon can you put together treatment recommendations?"

"My staff is working on it," he said. "We should be ready by the time we can start transfers."

"Good. Dr. House, I don't know how much vaccine they'll have available at first. I want you to triage hospital personnel for priority based on degree of exposure and critical position." House nodded silently. "Dr. Wilson, I want you coordinating personnel with me for patient treatment. More cases will be coming in from the other hospitals nearby. Let's get to work."

* * *

Katherine Jenson died one hour before morning.

"Encephalitis," Cameron said, her hands shaky around her coffee cup. "She just seized, out of nowhere, and..."

"It happens," House said. "How are you feeling? Any dizziness, trouble breathing?"

"No, I'm fine," she said, looking down at the vaccination spot on her arm. "We can still get it, can't we?"

"It's not too likely, getting vaccinated this soon after exposure," Wilson said. "And even if you do, it won't be as serious."

"Go get some sleep," House said. "They have cots set up downstairs." She nodded and left yawning.

"You should get some rest too," James said. "It's going to get worse later on."

"We had some sleep," House said, and drank more coffee.

The only thing on television was the national alert. Even the cable channels had switched over, from Sci Fi to Disney, all repeating the same litany. Outside the window there was a wall of flashing lights in the early grey morning: police cars parked end to end literally around the entire hospital. They'd ended up with sixty-odd cases, sixteen showing the lesions so far. Most of the hospital staff had been vaccinated and sent over to St. Peter's to help deal with the overcrowding there, and the halls were quiet and empty except for the CDC people carrying around their computers and setting up decontamination gear.

"We should look into putting UV light into the ventilation system to kill any airborne virus," Wilson said absently, looking out the windows at the strobing colors.

"If this lasts long enough for us to get around to that, we'll have other things to worry about," House said.

"I should call Julie." Wilson didn't get up, though, and mostly it sounded wistful.

" _Dr_. _House_ _to_ _the_ _tenth_ _floor_ _nurses'_ _station_ ," came over the paging system, echoing weirdly in the empty cafeteria. House pushed himself up and went to go watch another patient start to die.

* * *

Another two hundred and fifty patients came in over the next week. They divided them up among the floors by severity, rising upwards to the killing ground of the eleventh. House gave each incoming five minutes apiece, did a quick check of symptoms and sorted them as fast as he could, doing his best not to remember their names and faces.

Even so, occasionally one of them would do something that refused not to stick in his mind, and then a few days later he'd walk past a room on the higher floors and catch a glimpse of the outline of a familiar face, pustules turning the skin into nightmarish bubble-wrap shapes. When he had a choice, he spent most of his time on the lower floors and told himself, since no one else had attention to spare, that it was because those patients could benefit the most from a diagnosis of change in their condition.

He didn't see Wilson except when they bumped into each other in the cafeteria or the sleeping rooms downstairs. At the end of the week, House got paged up to eleven to diagnose an acute case of hemorrhagic smallpox. The patient was four months pregnant, so the diagnosis was actually useful; they hadn't wanted to risk giving her too much painkiller, before, when they thought there was a chance she and the baby might survive.

She was crying softly, her face more recognizable as human than most of the other victims, blotched with purple hemorrhages instead of the usual pustules, and she looked at him with conscious, aware eyes as they pumped morphine into her blood and managed to say, "Please, no, I want to -- I just want -- " before her eyes started to lose focus.

James' hand was warm on his shoulder for a moment, and then he was past and bending over the bed, taking the mottled, pain-clenched hand in his own, whispering to her, and one of the nurses brought him a chair and a cup of water without him even asking. House slipped out of the room and watched through the glass wall for the hour while she slid into the coma she wouldn't wake up from.

James came out with her blood still staining his scrubs and said gently, "Are you okay?"

"It's not clinical depression if there's a reason, right?" House said. "Because I'm thinking, if you've just lost more patients in one week than in your entire previous career, that seems like a pretty good reason. I mean, my statistics are never going to recover from this even if I do clinic hours from nine to five every day for the rest of my life."

James stripped off the scrubs and threw them in the biohazard container, then took House's scrubs off for him too. "Come on. Let's take a break."

House was vaguely aware that he was dissociating, and that was probably a bad thing, but at the moment it felt pretty good. James' hand on his arm felt even better, warm and solid.

The CDC personnel had taken over most of the office space including the Diagnostic Medicine conference room, but House had staked a claim to his own office simply by being bitingly rude to anyone who tried to invade. Four of the CDC people were sitting around the conference room table idly fiddling with the Scrabble set and talking about the spread pattern of the virus.

James led him past, nodding to them. Foreman was camped out in House's office, making phone calls. "Hey. I've been talking to the CDC guys and people at other tri-state hospitals, tracking the number of cases," he said, when they came in, gesturing at the map, now stuck in a corner of the office. "They think we've got the spread contained, but we still can't figure out how it got started."

"Not now," James said.

Foreman paused, looked at House more closely, and then got up and swept his papers up off the desk. "I'll see you guys later," he said, and left.

James closed all the office blinds and locked the doors, pushed House into the desk chair, and went down on his knees. About halfway through the blowjob, House fell back into his own body, said, "Jesus Christ, yes, please," and then, a few minutes later, "Wait -- wait -- "

James sat back breathing hard, mouth red and wet, looking crazily young in his t-shirt and white coat. "Wait?"

"I'm already forty-five, I've got to assume this is my one and only chance to have crazy life-affirming sex in a public place," House said, scrabbling through his desk drawers. "Let's go for something a little wilder."

"You do not have lubricant in that drawer."

"Oh, but I do," House said, pulling out the Maxim issue and yanking out the free sampler condom pack. "Complete with _Wet_ ," he said, waving it at James. "I knew it was worth hiding the subscription in my office expenses."

"I can't believe you." James shook his head. "So," he said, stretching out with a good attempt at casual. "Do you want to do me, or the other way around?"

"Under the circumstances, reality's on your side, but I'll make you give me a rematch later when we can get pillows involved," House said, doing a better job of faking the nonchalance. "Help me get down, would you?"

They'd never gone this far before; nothing more than a friendly hand now and then, the occasional blowjob. But neither of them discussed it any further, just stripped and got lined up on the floor, lying on their sides. James worked him open carefully, rocking back and forth in slow increments and gasping frantically into House's shoulder. "This would not be a good time to experience premature ejaculation," House said, panting.

"Yeah, that had occurred to me," James said, and gripped his hip. "Take a deep breath and relax for me."

"Clinical, yet strangely erotic," House said, and, "Oh, _fuck_ , yes."

"God," James said, and kissed the back of his neck, his shoulders, bit his ear, and all the while kept thrusting into him, shallowly because of the angle, but over and over, until it became a smooth easy glide, in and out, and he could get deeper still. House had lost his hard-on at some point, and his leg was not going to be grateful in about an hour, but he didn't care, surfing the endorphin high for what felt like forever until James finally groaned and said, "Greg, I have to -- " and reached around to grope him.

"Holy mother of god," House said, and came like a shot.

James eased him flat onto his back and gave him a couple of vicodin; also a leg massage, which under the circumstances House accepted as his due. "Though actually, what I really want right now is a cigar, a steak, and a glass of scotch," he said.

"God, don't talk about food." James flopped over onto his back. "The stuff they're feeding us -- I take back everything I ever said about the cafeteria before. I would kill for a corned beef on rye even with the soggy bread and the bad mustard."

"Government contractors, what do you expect," House said. He hitched himself over and lay his head on James' shoulder. At the moment, he didn't particularly care if it was pathetic. "Hm," he said.

"Hm?" James said drowsily.

"Help me up, would you?"

"You want to get up?" James said, not opening his eyes. House poked him in the side. "Ow. Okay, okay." He got up and levered House back onto his feet.

"You know, walking around the office naked feels almost more kinky than having sex," House said, limping heavily over to the map without his cane.

"Apparently, we had different kinds of sex just now," James said lying back down.

"I did say 'almost,' " House said. "Look at this." He tapped the orange clusters. "St. Mary's in Hoboken on this side of Manhattan, Jamaica Hospital on the other side. Those are the big ones. Then we've got a scattering in Manhattan itself, evenly distributed from about Soho to Central Park North, and a handful of other places here in Jersey, in Queens, and further out on Long Island."

James propped himself on his elbow, waking up enough to get interested. "And pretty much nothing in Connecticut or Brooklyn."

"Right," House said. "Then we've got the outlier cases, two in Boston, one in D.C., two in Philly. But no single center of origin. So where's the explanation?"

Wilson offered, "More than one attack? I know that's what the CDC has been assuming."

House shook his head. "No. It doesn't fit the facts. If that's what it was, we'd have multiple centers of origin, with overlapping rings of decreasing incidence. That's not what's going on here. Let's stick with the single attacker theory."

"Well, Manhattan would make the most sense as a single target. Biggest population density in a small space, big buildings with shared ventilation systems, tourists to panic, mass transit -- "

"Not tourists," House said abruptly. "It's not tourists. Where's Parsons School of Design?"

"It's in Manhattan? Near Chelsea, I think," Wilson said.

"That's where Katherine Jenson worked," House said. "My two other patients, the first day, they also worked in the city. _Commuters_. Wherever this attack is originating, it's mainly hitting commuters. It's the only thing that makes sense."

"My God." Wilson sat up. "Penn Station. The Long Island Railroad has a hub at Jamaica. The PATH train to Penn leaves from Hoboken,"

"And that's also the Amtrak station, which explains our outliers." House turned away from the map. "Come on. We've got to tell the CDC. The attacker could still be out there and contagious, unless he's already dead."

"Greg," James said.

"What?"

"Pants first."

* * *

"They caught her in the Amtrak vestibule," Foreman said. "She's in the hospital now, but they don't think she's going to make it to stand trial. She's pretty dehydrated and she's not trying to fight it."

"Ingenious," House said, rolling his cane between his hands. "The aba fabric probably actually helped the spread. Given that it was light enough not to block the particles, it would've diffused the virus more widely every time she coughed."

"So I guess at least that means that we won't be seeing any more new cases, I mean, without a known contact," Cameron said.

"Sure," House said. "Long as you ignore the possibility of someone innocent and stupid going around with febrile symptoms or the beginnings of the rash and infecting people without realizing it." He drained his coffee cup. "We've spent enough time on this. Let's get back to work."

Cameron caught up with him outside in the hallway. "So, why aren't you happier about this? You solved the case. Not to mention you raised the red flag fast enough this didn't turn into a real epidemic."

House gave her a dirty look and didn't stop walking. "Is that supposed to be a trick question? Designed to make me start railing at you, about how can we be happy when people are dying, and then I can break down and start crying and let it all out?"

She kept up with him. "It wouldn't kill you to admit you're taking it hard."

"Spare me the armchair psychology," House said. "You'd think you had enough patients available without hunting for more. How're the cidofovir test cases doing?"

"Too soon to tell if the improvement is statistically significant, but enough of them are doing better that we're putting the other patients on it, if they don't have kidney problems or sulfa allergies," she said. "And stop trying to change the subject. You can't just repress everything, it's going to blow up if you do. That's not armchair psychology, that's basic trauma care."

House stopped and turned on her narrowly. "Did Foreman put you up to this?"

She put her hands in her pockets and shrugged a little, without meeting his eyes. "He said it looked like you were having a psychotic break."

"And you thought you'd stage your very own intervention. How sweet." He started back down the hall. "You could've just sprung for chocolate. I think there are some boxes in the gift shop, if the CDC guys haven't looted it."

"I was worried, sue me," she said, rolling her eyes. House snorted. They waited for the elevators and got in together.

"So how long have you and Dr. Wilson been dating?" she asked casually as they rode up, steadfastly watching the numbers change instead of looking at him.

House eyed her suspiciously. "If we were, that would be your business because?"

"Just making conversation," she said.

"Hm." House didn't trust her perfect neutrality.

"It's really hot, two guys together," she volunteered, just before the doors slid open. "You know, thinking about it." Two nurses got on, preventing him from doing anything more than glaring at her. She just smiled and got off at the next floor with a wave.

"Nice," he muttered, acknowledging a hit.

Wilson was waiting for the elevators on the next floor. "Hey, I was just coming to look for you," he said, beckoning.

"Oh?" House got out and looked at the chart Wilson handed him.

"The mortality rate is dropping," Wilson said. "The cidofovir is helping, but it also looks like the early wave of patients were all at least mildly immunosuppressed, so especially vulnerable. How many new cases today?"

"Eight admitted since this morning, five of them transfers over from St. Peter's," House said.

"Those numbers sound good," Wilson said.

"Respectable," House said, grudgingly.

Wilson stopped in the hallway to glance inside a supply room, then he turned and pulled House inside with him.

"We need to stop meeting like this," House said. "People are starting to talk."

"I just want you to cheer up. We're beating this thing." Wilson pressed his thigh between House's legs, taking some of his weight, and started necking.

"But if I was happy, I wouldn't be getting all these fun interventions," House said, leaning back against the door cooperatively. "I like yours better, by the way."

"Than whose?"

"Cameron's. Did you know women get off on two guys together? She made a point of telling me."

"Uh." Wilson paused. "I hadn't really thought about it, no. How did she -- ?"

"Must be that female intuition thing," House said. "Or possibly she went in my office and noticed the condom wrappers on the floor."

* * *

About a week later, Cuddy called him down into her office. "I have good news. No new cases reported today outside the residential and contagious centers, at all, and the mortality rate is down to 7 percent. The outbreak is officially considered contained."

"Wow. So, can I go home now?" House asked. "Not that my adventures at Camp Princeton won't live in my heart forevermore -- "

"As it happens, the answer is yes," she said. "Your vaccination has officially taken, you aren't at risk for spreading the virus."

"I was kidding," House said. "You're actually sending me home?"

"The rest of our patients are being transferred to St. Mary's in Hoboken anyway. The CDC wants to consolidate their operations," Cuddy said. "And we're going to have to run a full decontamination before the hospital can reopen. Take the week off." She smiled, warmly for once. "Good work."

House blinked. "Well, thank you," he said. He made for the door pretty quickly, figuring there was no sense in giving her time to change her mind.

"Oh, and, by the way," she called.

"Yes?" he said warily, turning.

"Dr. Wilson can have the week too," she said.

"I'll... let him know," House said.

"Good." She smiled brightly. "You know, it really is kind of hot -- "

He couldn't run, but he hurried.

# End

**Works inspired by this one:**

  * [[Podfic] Pathogenesis and Intervention](https://archiveofourown.org/works/11318814) by [Twilight_Angel](https://archiveofourown.org/users/Twilight_Angel/pseuds/Twilight_Angel)




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